Basic Information
| Provider Information | |||||||||
| NPI: | 1932852779 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CALIFORNIA CANCER ASSOCIATES FOR RESEARCH AND EXCELLENCE, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 25100 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937295100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5593261238 | ||||||||
| FaxNumber: | 5593261230 | ||||||||
| Practice Location | |||||||||
| Address1: | 9850 GENESEE AVE STE 560 | ||||||||
| Address2: | |||||||||
| City: | LA JOLLA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920371229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8585521410 | ||||||||
| FaxNumber: | 5593261230 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/01/2022 | ||||||||
| LastUpdateDate: | 02/01/2022 | ||||||||
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| AuthorizedOfficialLastName: | MONSON | ||||||||
| AuthorizedOfficialFirstName: | JEDIDIAH | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 5593261238 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 02/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 3336S0011X | Y | Suppliers | Pharmacy | Specialty Pharmacy |
No ID Information.